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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Ketoacidosis

My 20 year old niece whom has had type 1 diabetes since age of 4. since January she has been in Icu for Ketoacidosis. her sugar is down to 258 but her BP is 80/30 even after 3 bags of fluid. she has not been vomiting nor profusely sweating. please help me understand what could be going on thanks
posted on Fri, 27 Jun 2014
Twitter Tue, 15 Jul 2014 Answered on
Twitter Wed, 16 Jul 2014 Last reviewed on
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Internal Medicine Specialist,  's  Response
Hi

Diabetic Ketoacidosis in which due to deficinecy of Insulin the blood sugars cannot be utilised by the body and hence the body utilises fat for energy production . Since Blood sugar is not utilised it gets excereted in urine causing severe dehydration .

So the management mainly depends on rehydration with IV fluids and correction of Blood sugars . A BP of 80/30 is low . It means they need to correct dehydration even more vigorously .

Ask them to insert a Central Line and monitor CVP and give IV fluids to maintain CVP pressure around 10. Also ask to check Arterial Blood PH and if its very low to correct it with Sodium Bicarbonate Injection .

If properly managed she will be alright within 2-3 days .
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Suggest Treatment For Ketoacidosis

Hi Diabetic Ketoacidosis in which due to deficinecy of Insulin the blood sugars cannot be utilised by the body and hence the body utilises fat for energy production . Since Blood sugar is not utilised it gets excereted in urine causing severe dehydration . So the management mainly depends on rehydration with IV fluids and correction of Blood sugars . A BP of 80/30 is low . It means they need to correct dehydration even more vigorously . Ask them to insert a Central Line and monitor CVP and give IV fluids to maintain CVP pressure around 10. Also ask to check Arterial Blood PH and if its very low to correct it with Sodium Bicarbonate Injection . If properly managed she will be alright within 2-3 days .